Launch of Out of Step 2017

5 July 2017 - Hamburg, Germany - Two days ahead of the G20 Leader’s Summit in Germany, the Stop TB Partnership and Médecins Sans Frontières (MSF) have released the third edition of 'Out of Step,' a report highlighting the need for governments and other stakeholders to increase efforts to combat tuberculosis (TB). The report reviews TB policies and practices in 29 countries and shows that countries can do much more to prevent, diagnose and treat people affected by TB.

The publication shows that large gaps remain in the adoption of new TB diagnostic tools and found that 15 of the 29 countries surveyed (52%) have introduced Xpert MTB/RIF, a rapid molecular test, as the initial test for TB, but only seven of these countries have implemented this policy widely. This means that after seven years of availability of Xpert MTB/RIF the majority of people in the countries surveyed are still tested with methods that fail to detect many people with TB, and may require a wait of up to several months to confirm the correct diagnosis.

"TB is an ancient killer, but we can end the disease by effective scale up use of new tools and guidelines that are currently available. The new Out of Step report shows that many countries are not making use of these advances, and as a result people are dying and the epidemic is continuing unabated," said Dr. Lucica Ditiu, Executive Director of The Stop TB Partnership.

"Despite the huge gaps, several countries have shown strong leadership in bringing their policies in line with international standards. The countries who had a policy in place for using Xpert MTB/RIF as the initial diagnostic test for all increased from 32% in our 2015 survey to 68% within the same group of countries surveyed in 2015. The countries with legal mechanisms to allow access to unregistered medicines increased from 65% in 2015 to 91% of countries in 2017. We hope countries will reach 100% adoption for all key policies by latest World TB Day on March 24th 2018," said Dr. Ditiu.

The Out of Step report shows for the first time progress on adoption of recently introduced TB guidelines. One year after the new WHO guidelines were released for the shortened nine month Drug-Resistant TB (DR-TB) treatment regimen, 45% of countries surveyed have included it in their policy. In addition, 50% of the countries have adopted the new pediatric fixed dose combinations for drug-sensitive TB as the standard of care, but only 29% of them have widely implemented this policy.

The report found that 34% of the countries surveyed had a policy requiring hospitalization for treatment of DR-TB. In the countries surveyed, 79% include the newer drug bedaquiline in their national guidelines, and 62% include delamanid in their guidelines; but globally, only 5% of people who could have benefitted had access to these drugs in 2016.

"With TB, the clock is ticking rapidly, as every 18 seconds a person dies of TB. We have to change that," said Sharonann Lynch, HIV and TB Policy Advisor at MSF’s Access Campaign. "The number of people diagnosed over the last four years has stalled, while the number of deaths has increased rather than decreased. Countries need to use new tools and step up the pace of their response."

The G20 governments are major contributors to the global TB response, with more than US$1.6 billion contributed to the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2016. In the same time, the G20 countries account for 54% of the global TB burden.

Ahead of the G20 Leaders Summit, the Stop TB Partnership and MSF are calling on G20 leaders to mobilize their resources to get more people diagnosed, make effective diagnostics and treatments accessible to all people affected by TB, and to highlight the importance of fighting TB in their G20 Summit Leaders Declaration.

The Stop TB Partnership and MSF have launched a campaign to urge governments to bring their TB policies and practices in line with WHO recommendations by World TB Day 2018, called #StepUpforTB.